Type 2 diabetes (T2D) is a growing public health concern, disproportionately impacting racial and ethnic minorities. Assessing disparities is the first step towards achieving the translation goal to reduce disparities in diabetes outcomes, according to the Centers for Disease Control and Prevention (CDC)’s Division of Diabetes. We analyzed the data of patients (18+ years) diagnosed with T2D between 1 January 2012 and 31 March 2017, using the electronic health records of the University of Texas Medical Branch at Galveston. We compared the crude rate and age-standardized rate (using direct method) of selected micro- and macrovascular complication rates, associated obesity, and insulin dependence among racial and ethnic groups. Our sample included 20,680 patients who made 394,106 visits (9922 non-Hispanic White patients, 4698 non-Hispanic Black patients, and 6060 Hispanic patients). Our results suggest a higher risk of acquiring macrovascular (hypertension, ischemic disease, and stroke) and microvascular (renal, ophthalmic, and neurological) complications in Black patients compared to non-Hispanic White and Hispanic patients. The rates of stage I or II obesity were higher in Black patients compared with White and Hispanic patients. The rates of insulin use rather than oral hypoglycemics were also higher in Black patients than White and Hispanic patients. The disparities in terms of the higher susceptibility to complications among Black patients are possibly linked to the socioeconomic disadvantages of this population, leading to poorer management. Prevention strategies are warranted to reduce the incidence of T2D complications in racial minorities.
Adolescent refugees experience psychosocial stressors, including traumatic events, poverty, and loss of home and family. Exposure to conflict affects mental well-being in Palestinian adolescent refugees. Adolescent girls are among those vulnerable to post-traumatic stress associated with living in conflict zones, We assessed the association between reported mental well-being and school attendance among Palestinian adolescent refugees in UNRWA schools in Occupied Palestinian Territories, Jordan, Lebanon, and Syria. We also examined differences based on gender and place of residence, Palestinian adolescent refugees with certain mental well-being concerns were more likely to miss more days of school. Generally, females reported higher rates of loneliness and worry, but males were more likely to miss school. Gender-based differences were highest in Lebanon and least in the West Bank, More school-based and community-based mental well-being interventions are needed. Female-tailored programs are needed, especially in Palestinian refugee camps in Lebanon.
18 August 2017 in Social Psychiatry and Psychiatric Epidemiology